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Paragraphs |
| About this guidance |
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| How this guidance applies to you |
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Guidance
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1-6 |
| Principles |
7-13 |
| Equalities and human rights |
7-9 |
| Presumption in favour of prolonging life |
10 |
| Presumption of capacity |
11 |
| Maximising capacity to make decisions |
12 |
| Overall benefit |
13 |
| Decision-making models |
14-16 |
| Patients who have capacity to decide |
14 |
| Adults who lack capacity to decide |
15-16 |
| Working with the principles and decision-making models |
17-89 |
| Role of relatives, partners and others close to the patient |
17-21 |
| Working in teams and across service boundaries |
22-23 |
| Making sound clinical judgements |
24-27 |
| Explaining the clinical issues |
28-30 |
| Addressing uncertainty |
31-32 |
| Emotional difficulties in end of life decision making |
33-36 |
| Resource constraints |
37-39 |
| Assessing the overall benefit of treatment options |
40-46 |
| Weighing the benefits, burdens and risks |
40-43 |
| Avoiding bias |
44-46 |
| Resolving disagreements |
47-49 |
| Advance care planning |
50-62 |
| The benefits |
50-51 |
| What to discuss |
52-55 |
| When patients do not want to know |
56-58 |
| When others want information to be withheld from the patient |
59 |
| Formalising a patient's wishes |
60 |
| Recording and sharing the advance care plan |
61-62 |
| Acting on advance requests for treatment |
63-66 |
| Acting on advance refusals of treatment |
67-74 |
| When advance refusals are binding |
68 |
| Non-binding advance refusals |
69 |
| Assessing the validity of advance refusals |
70 |
| Assessing the applicability of advance refusals |
71 |
| Doubt or disagreement about the status of advance refusals |
72-74 |
| Recording and communicating decisions |
75-77 |
| Reviewing decisions |
78 |
| Conscientious objections |
79-80 |
| Organ donation |
81-82 |
| Care after death |
83-87 |
| The wishes and needs of the bereaved |
84 |
| Certification, post-mortems and referral to the coroner or procurator fiscal |
85-87 |
| Training and audit |
88-89 |
| Neonates, children and young people |
90-108 |
| Considering the benefits, burdens and risks of treatment |
92-96 |
| Making the decision |
97-98 |
| Children and young people who have capacity |
99-103 |
| Children and young people who lack capacity |
104-105 |
| Neonates and infants |
106 |
| Parents' concerns and anxieties |
107 |
| Resolving disagreements |
108 |
| Meeting patients' nutrition and hydration needs |
109-111 |
| Clinically assisted nutrition and hydration |
112-127 |
| Patients who have capacity |
116-117 |
| Adult patients who lack capacity |
118 |
| Adult patients who lack capacity and are not expected to die within hours or days |
119-122 |
| Adult patients who lack capacity and are expected to die within hours or days |
123-125 |
| Patients in a persistent vegetative state (PVS) or similar condition |
126 |
| Conscientious objection |
127 |
| Cardiopulmonary resuscitation (CPR) |
128-146 |
| When to consider making a Do Not Attempt CPR (DNACPR) decision |
129-131 |
| Discussions about whether to attempt CPR |
132-133 |
| When CPR will not be successful |
134-136 |
| When CPR may be successful |
137-141 |
| Patients who have capacity |
137-139 |
| Patients who lack capacity |
140-141 |
| Resolving disagreements |
142 |
| Recording and communicating CPR decisions |
143 |
| Treatment and care after a DNACPR decision |
144-145 |
| Emergencies and CPR |
146 |
| References |
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| Legal Annex |
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| Glossary of terms |
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